Healthcare Provider Details

I. General information

NPI: 1134269657
Provider Name (Legal Business Name): PRECHA SUVUNRUNGSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 S CLEAR CREEK RD
KILLEEN TX
76549-4110
US

IV. Provider business mailing address

2109 S CLEAR CREEK RD
KILLEEN TX
76549-4110
US

V. Phone/Fax

Practice location:
  • Phone: 254-526-6604
  • Fax: 254-526-9606
Mailing address:
  • Phone: 254-526-6604
  • Fax: 254-526-9606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE0159
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: